Provider Demographics
NPI:1265910491
Name:CREHAN, PATRICK H (NP)
Entity type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:H
Last Name:CREHAN
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:739 IRVING AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-1605
Mailing Address - Country:US
Mailing Address - Phone:315-470-7747
Mailing Address - Fax:315-470-7758
Practice Address - Street 1:739 IRVING AVE STE 340
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-1605
Practice Address - Country:US
Practice Address - Phone:315-470-7747
Practice Address - Fax:315-470-7758
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF343379-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner